AAN 2023 | RBD: current therapeutic interventions

Eric Geil, MD, Miami Veterans Affairs Healthcare System, Miami, FL, explains current treatment options for REM sleep behavioral disorder (RBD). Treatment depends on the severity of symptoms and the presence of co-morbidities and is only required if the patient is injuring themselves or their bed partner. Doctors recommend that all patients maintain a safe sleep environment. For patients whose dream enactment could cause injuries, drugs such as clonazepam, melatonin, pramipexole, and transdermal rivastigmine are available. Clonazepam should be avoided for patients who have untreated sleep apnea or risk of falls, with melatonin being the better option in this situation. For younger patients with no co-morbidities, clonazepam can be prescribed at a low dose. Medications can be combined for patients that are particularly difficult to treat. This interview took place at the American Academy of Neurology Annual Meeting 2023 in Boston, MA.

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